Appendix 2: Tables

SNAC-recommended Initial Core Set, September 18, 2009

Table A: Measures that Met the Criteria Thresholds for Validity, Feasibility, and Importance But Were Not Recommended for Inclusion in the Core Set

Internal SNAC/AHRQ Control #	Measure Label
Prevention and Health Promotion
*Prenatal/Perinatal*
PHP-3	Smoking Cessation and Prevention: Pregnant women
PHP-26B	HRSA MCH Health Status Indicator #01B—% of live singleton births weighing less than 2,500 gms
PHP-26C	HRSA MCH Health Status #02A—% of live births weighing less than 1500 gms
PHP-26D	HRSA MCH Health status #02B—% of live singleton births weighing less than 1500 gms
PHP-31	MCHB National performance measure #8—the rate of birth (per 1,000) for teenagers aged 15-17 years
PHP-32	Proportion of infants 22-29 weeks gestation treated with surfactant who are treated within 2 hours of birth
PHP-34	Health systems capacity indicator #04-% of women 15-44 with a live birth during the year whose observed to expected prenatal visits are greater than or equal to 80% on the Kotelchuck Index
PHP-36A	Rate of elective delivery prior to 39 completed weeks gestation
*Immunizations*
PHP-5B	Two-year-old Immunization Measure—Assessing immunizations by timeliness and the ACIP/AAP/CDC schedule versus HEDIS dose counting (OR)
*General Screening*
PHP-17	Newborn Hearing Screening
PHP-18	Vision screening—use MEPS description and performance data
*Social/Behavioral Health Screening*
PHP-33A	Administration of SDBS (Standardized screening tools social and emotional (CMWF/CAHMI))
*Dental/Oral Health*
PHP-42	Total eligibles receiving any dental services (EPSDT measure Line 12A)
PHP-43A	HRSA Oral Health Measures WG Measure—% of children age 12-72 mos with 1 or more fluoride varnish apps documented
Management of Acute Conditions
*Acute Upper Respiratory Tract Illness*
AC-1	Upper respiratory infection—appropriate treatment
*Acute Otitis Externa*
AC-11	Acute Otitis Externa—Topical therapy
AC-13	Acute Otitis Externa—Systemic antimicrobial therapy-avoidance of inappropriate use
*Otitis Media with Effusion*
AC-14	OME Diagnostic evaluation—assessment of tympanic membrane mobility
AC-18	OME—systemic corticosteroids—avoidance of inappropriate use
*Inpatient Care*
AC-5	Foreign body left after procedure (PDI 3)
AC-6	Iatrogenic pneumothorax in non-neonates (PDI)
AC-20	Care transitions—transition record with specified elements received by discharged patients—Inpatient
AC-23	Central line associated bloodstream infection (PDI 12)
AC-24	Accidental puncture and laceration
AC-25	Decubitus ulcer
AC-26	AHRQ Pediatric Quality Indicator Composite Measure (Patient Safety Composite)
*ED Care*
AC-21	Care transition—transition record with specified elements reviewed by discharged patients-ED
Management of Chronic Conditions
Mental and Behavioral Health/Substance Use
*ADHD Care*
CC-1	Followup care for children prescribed attention-deficit/hyperactivity disorder (ADHD) medication (Initiation Phase; NCQA measure)
*HIV*
CC-8A	HIV/AIDS Bureau quality performance measure—percentage of clients with AIDS who are prescribed HAART
CC-23	HIV AIDS Bureau Measure—% of clients with HIV infection who had two or more CD4 T-cell counts performed in the measurement year
CC-24	HRSA HIV/AIDS QPR % of clients with HIV who had two or more medical visits in an HIV setting in the measurement year
*Asthma*
CC-10	Asthma — appropriate medications
CC-10B	Use of Appropriate Medications for People 5-20 years of age with Asthma – Average number of member controller months
CC-18	Annual influenza vaccination (all children and adolescents diagnosed with asthma)
CC-20	Annual number of asthma patients (>1 year old) with >1 asthma-related hospitalization
*Diabetes*
CC-14	Annual lipid profile (adolescents with diabetes >16 years old)
CC-16	Annual eye examination (adolescents with diabetes >16 years old)
CC-17	Annual influenza vaccination (all children and adolescents diagnosed with diabetes)
*End-Stage Renal Disease*
CC-33	Pediatric end-stage renal disease—Plan of care for inadequate hemodialysis
CC-34	Pediatric end-stage renal disease—influenza immunization
*Duration of Enrollment*
D-2	Retrospective duration measure

Source: AHRQ, based on SNAC Delphi II scoring and September 17-18, 2009, SNAC meeting.

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Table B: Measures that Did Not Meet Criteria Thresholds for Scoring on Validity, Feasibility, and Importance

Control Number	Measure Label
PREVENTION AND HEALTH PROMOTION
Prenatal/Perinatal
PHP-1A	HRSA MCH MPR #18—% of infants born to pregnant women receiving prenatal care beginning in the first trimester (data source—nvss—differs from NCQA; Medicaid/CHIP specific not available from NVSS.
PHP-26	Percentage of low birth weight (PDI—hospital discharge data)
PHP-27	Postpartum care visit NCQA measure
PHP-30	MCHB National performance measure #17—percent of VLBW infants delivered at facilities for high-risk deliveries and neonates
PHP-30A	Under 1500g infant Not Delivered at Appropriate Level of Care
PHP-36	Elective delivery prior to 39 weeks gestation
PHP-40	HRSA MCH NPR MEASURE #11—% of mothers who breastfeed their infants at 6 mos of age
PHP-41	HRSA MCH NPR #15—% of women who smoke in the last 3 months of pregnancy
Immunizations
PHP-8	Immunization reporting (provider registry)
Adolescent Preventive Services
PHP-11	Adolescent Well-Care Visits (NCQA)
PHP-15	Adolescent receipt of the following seven components of care during the measurement year: BMI percentile, assessment/counseling/education on nutrition, physical activity, risk behaviors associated with sexual health/activity/preventive actions, depression screening
PHP-16	Smoking Cessation and Prevention: adolescent tobacco users
General Screening
PHP-19	Weight Assessment and Counseling for Nutrition and Physical Activity for children and adolescents
PHP-19B	Nutrition counseling—NCQA
PHP 19C	Physical Activity Counseling (NQCA)
PHP-29	Lead screening rate (NCQA—1st year measure—see confidential data); note USPSTF recommendation
PHP-29A	Lead screening 2nd year—% of members who turned age 2 during the reporting period and received a lead test (data from MaineCare claims and the Maine CDC)
PHP-29B	Lead screening 1st year—% of members who turned age 1 during the reporting period and received a lead test (data from MaineCare Claims and Maine CDC)
PHP-29C	HRSA Lead screening in children by 2 years of age (data source differs from NCQA)
PHP-39	EPSDT—Percentage of members 0-20 years old who had one or more EPSDT procedure(s) during the reporting period
Social/Behavioral Health Screening
PHP-37	Percent of members under age 21 with a WCC visit by any provider during the measurement period who had a BH screen.
Dental/Oral Health
PHP-22A	HRSA oral health measure—the percentage of patients who had at least one dental visit during the measurement year (differs from NCQA—data source is CHCs; broader age range)
PHP-35	HRSA oral health measure — percentage of all dental patients with a comprehensive or periodic recall oral exam within a 12 month period
MANAGEMENT OF ACUTE CONDITIONS
Acute Otitis Externa
AC-12	Acute Otitis Externa—Pain Assessment
Otitis Media with Effusion
AC-15	Otitis Media with Effusion—Hearing testing
*Dental*
AC-8	HRSA oral health measure—percentage of all dental patients for whom the Phase I treatment plan is completed within a 12-month period
AC-9	HRSA oral health performance measure—percentage of all dental patients with a comprehensive or periodic recall oral exam, for whom the Phase I treatment plan is documented
Inpatient Care
AC-7	PICU pain assessment on admission
AC-19	Care transitions—reconciled medication list received by discharged patients
AC-22	Care transitions—timely transmission of transition record (from input)
*ED Care*
AC-10	ER Utilization - Average number of emergency room visits per member per reporting period
AC-21	Care transition—transition record with specified elements received by discharged patients-ED
MANAGEMENT OF CHRONIC CONDITIONS
Mental and Behavioral Health/Substance Use
*ADHD Care*
CC-6	Diagnosis of ADHD in primary care for school age children and adolescents (using DSM)
*Depression Care*
CC-27	Child and adolescent Major Depressive Disorder (MDD)—interview of adolescent or child
CC-28	Child and adolescent Major Depressive Disorder(MDD)—diagnostic evaluation
CC-30	Child and adolescent Major Depressive Disorder (MDD)—psychotherapy
CC-32	Child and adolescent Major Depressive Disorder (MDD)—follow-up care
*Other Mental Health/Behavioral Care*
CC-4	Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (ages 3-17 and 18+)
CC-35	Medication adherence as measured by maximal gaps in days during a calendar year for ADHD and anti-psychotics medication in children
*Children with Special Health Care Needs*
CC-37	CSHCN number of missed school days due to illness or injury
*HIV*
CC-8	Highly active anti-retroviral treatment
*Asthma*
CC-25	Percentage of patients for whom there is documentation that a written asthma management plan was provided to the patient or the patient's caregiver OR at minimum instructions on under what conditions the patient's doctor should be contacted or the patient should go to the emergency room.
*Chronic Disease Identified through Newborn Screening*
CC-12	Timely follow-up of positive newborn screens
*Diabetes*
CC-15	Annual urine protein screening (adolescents with diabetes > 16 years-old)
CC-21	Hemoglobin A1c test for pediatric patients
FAMILY EXPERIENCES WITH CARE
Other Family/Patient Experiences of Care Measures
FEC-2	Helpfulness of counseling (adolescent reported)
FEC-3	Communication and experience of care (adolescent reported)
FEC-4	Dental CAHPS® (overall ratings of dentist, dental plan, dental care, office staff)
MOST INTEGRATED HEALTHCARE SYSTEMS
MIH-2	Medical home measure using subset of HEDIS CAHPS® MEDICAID 4.0 survey items
AVAILABILITY OF SERVICES
AV-1	Unduplicated members served per provider
*Use of Services*
US-1	Utilization of ambulatory services
US-2	Outpatient drug utilization—per member per year average number of prescriptions
US-3	Utilization of inpatient care
*Access to Services*
HEALTH STATUS
HS-2	PROMIS Pediatric item Banks: physical function, emotional distress, social role relationship, fatigue, pain, and asthma
DURATION OF ENROLLMENT
D-1	Prospective duration measure

Key:
V = Validity
F = Feasibility
I = Importance
IQR = Inter-Quartile Range
N = Number of Subcommittee members rating measure

Page last reviewed January 2010

Internet Citation: Appendix 2: Tables: SNAC-recommended Initial Core Set, September 18, 2009. January 2010. Agency for Healthcare Research and Quality, Rockville, MD. https://archive.ahrq.gov/policymakers/chipra/coreset/coresetap2.html